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Transurethral resection of prostate (TURP) syndrome during hysteroscopic surgery is a severe complication due to the absorption of irrigating fluids and pressure in uterine cavity, fluid overload and/or dilution hyponatremia cause a series of clinical symptoms. It can be a dread complication if it is not timely diagnosed and treated. The relevant pathophysiology of TURP syndrome was discussed through the analysis on four typical cases, the relative major factors include high-pressure perfusion and venous sinuses open during the surgery. The principles of preventive measures and treatments of this complication were discussed in order to strengthen the safety awareness of doctors, to reduce the incidence of this complication. [ABSTRACT FROM AUTHOR]

Kinetics of anaerobic ammonium oxidation (anammox) reaction in marine anammox bacterial culture was first investigated. The nitrogen removal performance of the reactor was compared with prediction of Monod model, modified Stover–Kincannon model, first-order and the Grau second-order substrate removal models. Based on calculations, Monod model, modified Stover–Kincannon model and the Grau second-order model proved to be more appropriate to describe the nitrogen removal kinetics of the reactor than first-order model with high determination coefficients of 0.993, 0.993 and 0.991, respectively. According to the modified Stover–Kincannon model, the maximal substrate removal rate (r m) and saturation rate constant (K B) were suggested as 7.37 and 6.41 g N/L/d, respectively. In addition, in light of the Monod model, the saturation concentration (K s) and the maximal specific substrate removal rate constant (R m) were determined to be 0.107 g/L and 0.952 g N/g MLVSS/d, respectively. Moreover, model evaluation was carried out by assessing the linear correlation between measured and predicted values. Both kinetics study and model evaluation showed that Monod model, modified Stover–Kincannon model and the Grau second-order substrate removal models could be used to describe the kinetic behavior or design of the marine anammox reactor. [ABSTRACT FROM AUTHOR]

A new triterpenoid saponin, named 3-O-β-d-glucopyranosyl-(1 → 3)-β-d-xylopyranosyl-(1 → 2)-[α-l-rhamnopyranosyl-(1 → 3)]-β-d-glucopyranosyl-(1 → 4)-[β-d-glucopyranosyl-(1 → 2)]-α-l-arabinopyranosyl-3β,16α,28,30-tetrahydroxy-olean-12-ene (1), along with four known triterpenoids (2–5), was isolated from the rhizomes ofArdisia gigantifolia. Their structures were elucidated by spectroscopic methods. Compounds1–4showed cytotoxic activity against Hela, EJ, BCG, and HepG-2 cell lines. The percentage of early apoptotic cells after treatment with1was significantly increased compared with control cells (p < 0.05). [ABSTRACT FROM PUBLISHER]

Screening of new microorganism being able to produce efficiently flocculants was carried out. A new model for screening efficient flocculant-producing strains was designed and tested. The results showed that this model for screening efficient flocculant-producing strains is very reliable and can greatly shorten the screening period. 13 flocculant-producing strains were isolated from activated sludge by conventional method. A strain, designated as HHE6, produced the bioflocculant with the turbidity removal 98% for kaolin suspension. Six of 13 strains selected as the original strains were treated with NTG as mutagen, and five mutant strains (HHE-P7, HHE-A8, HHE-P21, HHE-P24, HHE-A26) with high flocculation efficiency was obtained by selection, which exhibited the flocculation rate for kaolin suspension above 90%. Strains HHE6, HHE-P7, and HHE-P24 were classified as Penicillium purpurogenum, HHE-P21 as Penicillium cyclopium, HHE-A26 as Aspergillus versicolor and HHE-A8 as Aspergillus fumigatus, and it is hitherto unreported for biofloccutant-producing strains of Penicillium. The growth of the six strains (HHE6, HHE-P7, HHE-A8, HHE-P21, HHE-P24, HHE-A26) had similar curves, i.e. firstly increasing rapidly, keeping relatively constant then and finally decreasing gradually with cultivation time. The production of bioflocculants by strains showed the similar pattern to strain growth. [ABSTRACT FROM AUTHOR]

Anammox is an efficient and carbon-saving process for biological nitrogen removal; however, the long start-up period and poor stability of anammox bioreactors hinder their application in wastewater treatment. An innovative technical strategy was developed in this study that used a packed-bed biofilm reactor (PBBR) to grow healthy anammox biofilms for the fast start-up of bioreactors. With a greatly reduced fluid turbulence in the PBBR, the attachment and growth of anammox biofilms were found to be accelerated and the specific anammox biofilm formation rate was 60% higher than that in the conventional moving-bed biofilm reactor (0.032 vs. 0.020/d). In the PBBR operation, maintaining a low free ammonia (<2.7 mg/L) and free nitrous acid (<5.8 μg/L) concentrations in the early stage and stepwise increasing the nitrogen load also assisted the biofilm formation. With the rapid anammox biofilm formation and growth, the nitrogen removal capacity of the PBBR increased from 77.6 to 876.8 mg N/(L·d) in 2 months. The anoxic condition and prolonged sludge retention time in the PBBR also benefited the growth of fermentative bacteria and denitrifiers, which induced the partial denitrification–anammox process and decreased the nitrate accumulation by 50%. [Display omitted] • Low turbulent condition in PBBR improved the biofilm formation rate by 60%. • Low FA (<2.7 mg/L) and FNA (<5.8 μg/L) benefited anammox growth and N removal. • PBBR provides a reliable technique for rapid start-up of anammox biofilm reactors. [ABSTRACT FROM AUTHOR]

In order to analyze the axial compressive properties of ultra-high-toughness cementitious composite (UHTCC)-confined recycled aggregate concrete (RAC), a batch of UHTCC-confined RAC components was designed and manufactured according to the requirements of GB/T50081-2002 specifications. After analyzing the surface failure phenomenon, load-displacement curves, scanning electron microscope (SEM), and parameter analysis of the specimen, the result shows that UHTCC-confined RAC is an effective confinement method, which can effectively improve the mechanical properties and control the degree of surface failure of RAC structures. Compared with the unconfined specimen, the maximum peak load of the UHTCC confinement layer with a thickness of 10 mm and 20 mm increased by 44.61% and 79.27%, respectively, meeting the requirements of engineering practice. Different fiber mixing amounts have different effects on improving the mechanical performance of RAC structural. The specific rule was steel fiber (SF) > polyvinyl alcohol fiber (PVAF) > polyvinyl alcohol fiber (PEF) > no fiber mixture, and the SF improves the axial compression properties of UHTCC most significantly. When there are strict requirements for improving the mechanical properties of the structure, SF should be added to UHTCC. On the contrary, PVAF should be added to UHTCC. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to investigate key long noncoding RNAs (lncRNAs) involved in competitive endogenous RNA (ceRNA) network associated with laryngeal squamous cell carcinoma (LSCC). Materials and Methods: Three mRNA datasets, two miRNA datasets, and one lncRNA dataset of LSCC were downloaded from GEO database. Following the identification of differentially expressed mRNAs (DEmRNAs), (microRNAs) miRNAs (DEmiRNAs), and lncRNAs (DElncRNAs) in LSCC compared with adjacent tissues, functional enrichment of DEmRNAs was performed. Then, construction of the ceRNA (DElncRNA‐DEmiRNA‐DEmRNA) regulatory network and functional analyses of all DEmRNAs in ceRNA regulatory network were conducted. Quantitative real‐time polymerase chain reactions (qRT‐PCR) were used to detect the expression levels of selected DEmRNAs, DEmiRNAs, and DElncRNAs. Results: A total of 3449 DEmRNAs, 40 DEmiRNAs, and 100 DElncRNAs were identified in LSCC. The ceRNA networks, which contained 132 DElncRNA‐DEmiRNA pairs and 287 DEmiRNA‐DEmRNA pairs, involving 44 lncRNAs, 3 miRNAs, and 271 mRNAs, were obtained. DEmRNAs in ceRNA regulatory networks were significantly enriched in pathways in cancer, prostate cancer, and aldosterone‐regulated sodium reabsorption. Except for HCG22 and hsa‐miR‐1246, expressions of the others in the qRT‐PCR results played the same pattern with that in our integrated analysis, generally. Conclusions: We concluded that HCG22/EGOT‐hsa‐miR‐1275‐FAM107A and HCG22/EGOT‐hsa‐miR‐1246‐Glycerol‐3‐phosphate dehydrogenase 1 like interaction pairs may play a central role in LSCC. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic liver resection (LLR) has now been established as a safe and minimally invasive technique that is deemed feasible for treating hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). However, the role of LLR in treating combined hepatocellular-cholangiocarcinoma (cHCC-CC) patients has been rarely reported. This study aimed to assess the efficacy of LLR when compared with open liver resection (OLR) procedure for patients with cHCC-CC. Methods: A total of 229 cHCC-CC patients who underwent hepatic resection (34 LLR and 195 OLR patients) from January 2014 to December 2018 in Zhongshan Hospital, Fudan University were enrolled and underwent a 1:2 propensity score matching (PSM) analysis between the LLR and OLR groups to compare perioperative and oncologic outcomes. Overall survival (OS) and recurrence-free survival (RFS) parameters were assessed by the log-rank test and the sensitivity analysis. Results: A total of 34 LLR and 68 OLR patients were included after PSM analysis. The LLR group displayed a shorter postoperative hospital stay (6.61 vs. 8.26 days; p value < 0.001) when compared with the OLR group. No significant differences were observed in the postoperative complications' incidence or a negative surgical margin rate between the two groups (p value = 0.409 and p value = 1.000, respectively). The aspartate aminotransferase (AST), alanine aminotransferase (ALT), and inflammatory indicators in the LLR group were significantly lower than those in the OLR group on the first and third postoperative days. Additionally, OS and RFS were comparable in both the LLR and OLR groups (p value = 0.700 and p value = 0.780, respectively), and similar results were obtained by conducting a sensitivity analysis. Conclusion: LLR can impart less liver function damage, better inflammatory response attenuation contributing to a faster recovery, and parallel oncologic outcomes when compared with OLR. Therefore, LLR can be recommended as a safe and effective therapeutic modality for treating selected cHCC-CC patients, especially for those with small tumors in favorable location. [ABSTRACT FROM AUTHOR]

Background & Aims: Liver transplantation (LTx) is one of the most effective treatments for hepatocellular carcinoma (HCC); however, tumour recurrence after LTx often leads to poor outcomes. This study investigated the value of circulating tumour cells (CTCs) as a predictor of recurrence following LTx in patients with HCC. Methods: This analysis included 193 patients with HCC who underwent LTx at our institute and accepted pre‐ and post‐operative CTC detection; 38 were selected for serial CTC monitoring. The predictive value of CTCs for tumour recurrence in patients with HCC following LTx was evaluated. Single‐cell whole genome sequencing was used to characterize CTCs. Results: Overall, the CTC burden decreased after LTx (P <.05). Post‐operative CTC count ≥ 1 per 5 mL peripheral blood was identified as a potential biomarker for predicting tumour recurrence after LTx, especially in patients with no detectable CTCs prior to LTx and negative tumour serological biomarkers. The predictive value of post‐operative CTC count ≥ 1 per 5 mL blood was retained in patients who did not meet the Milan criteria, University of California San Francisco (UCSF) criteria, or Fudan criteria (all P <.05). Furthermore, post‐operative serial CTC detection may be useful in post‐surgical surveillance for HCC recurrence. Conclusions: CTCs may be a useful biomarker to evaluate recurrence risk following LTx in patients with HCC. Evaluation based on CTC detection may enhance the post‐transplant management of HCC, and improve the therapeutic efficacy of LTx. [ABSTRACT FROM AUTHOR]

• 182 Chinese hepatocellular carcinomas were sequenced. • WNK2 , RUNX1T1 , CTNNB1 , TSC1 , and TP53 somatic mutations correlated with early tumor recurrence after curative resection. • WNK2 displayed somatic mutation, copy number loss, and downregulated expression in HCC. • WNK2 deficiency leads to ERK1/2 signalling activation, TAM infiltration, and tumor growth and metastasis. Early recurrence of hepatocellular carcinoma (HCC) after curative resection is common. However, the association between genetic mechanisms and early HCC recurrence, especially in Chinese patients, remains largely unknown. We performed whole-genome sequencing (49 cases), whole-exome sequencing (18 cases), and deep targeted sequencing (115 cases) on 182 primary HCC samples. Focusing on WNK2 , we used Sanger sequencing and qPCR to evaluate all the coding exons and copy numbers of that gene in an additional 554 HCC samples. We also explored the functional effect and mechanism of WNK2 on tumor growth and metastasis. We identified 5 genes (WNK2 , RUNX1T1 , CTNNB1 , TSC1 , and TP53) harboring somatic mutations that correlated with early tumor recurrence after curative resection in 182 primary HCC samples. Focusing on WNK2 , the overall somatic mutation and copy number loss occurred in 5.3% (39/736) and 27.2% (200/736), respectively, of the total 736 HCC samples. Both types of variation were associated with lower WNK2 protein levels, higher rates of early tumor recurrence, and shorter overall survival. Biofunctional investigations revealed a tumor-suppressor role of WNK2: its inactivation led to ERK1/2 signaling activation in HCC cells, tumor-associated macrophage infiltration, and tumor growth and metastasis. Our results delineate genomic events that characterize Chinese HCCs and identify WNK2 as a driver of early HCC recurrence after curative resection. We applied next-generation sequencing and conducted an in-depth genomic analysis of hepatocellular carcinomas from a Chinese patient cohort. The results delineate the genomic events that characterize hepatocellular carcinomas in Chinese patients and identify WNK2 as a driver associated with early tumor recurrence after curative resection. [ABSTRACT FROM AUTHOR]

Clinical response of hepatocellular carcinoma (HCC) to arsenic trioxide (ATO) has been poor. Promyelocytic leukemia protein (PML) is central to ATO treatment efficacy of acute promyelocytic leukemia. We examine impacts of PML expression on the effectiveness of ATO treatment in HCC. We show that increased PML expression predicts longer survival and lower cancer recurrence rates after HCC resection. However, high PML expression dampens the anti-tumor effects of ATO in HCC cells. Gene microarray analysis shows that reduced PML expression significantly down-regulates expression of aldehyde dehydrogenase 3 family member A1 (ALDH3A1). ALDH3A1 depression facilitates accumulation of ATO-induced reactive oxygen species. Chromatin immunoprecipitation analysis and promoter activity assays confirm that PML regulates ALDH3A1 expression through binding to the promoter region of ALDH3A1. Clinically, ATO treatment decreases the disease progression rate in advanced HCC patients with negative PML expression. In conclusion, PML confers a favorable prognosis in HCC patients, but it induces ATO resistance through ALDH3A1 up-regulation in HCC cells. ATO is effective for HCC patients with negative PML expression. Combined with an ALDH3A1 inhibitor, ATO may be efficacious in patients with positive PML expression. [ABSTRACT FROM AUTHOR]

Upregulation of CXCR2 in tumor cells has been documented in several types of cancer. As one of its ligands, CXCL5 is associated with neutrophil infiltration and poor prognosis in hepatocellular carcinoma (HCC). However, little is known about the role of the CXCR2/CXCL5 axis in the invasion and metastasis of HCC cells. In this study, we examined CXCR2 expression in human HCC cell lines and in three independent cohorts of HCC patients. The molecular effects of high expression levels of CXCR2 and CXCL5 in HCC cells were determined using qRT-PCR, western blot analysis, immunofluorescence, matrigel invasion assay, and xenograft mouse models. We found that high levels of CXCR2 correlated with progression and poor prognosis in human HCC. CXCR2/CXCL5 together promoted cell spreading by inducing the epithelial-mesenchymal transition (EMT) through activation of the PI3K/Akt/GSK-3β/Snail signaling pathway. In clinical HCC samples, high expression of both CXCR2 and CXCL5 showed a significant correlation with the activation of PI3K/Akt/GSK-3β/Snail signaling and EMT phenotype. In conclusion, our data showed that the CXCR2/CXCL5 axis contributes to EMT of HCC cells through activating PI3K/Akt/GSK-3β/Snail signaling, and it may serve as a potential therapeutic target. [ABSTRACT FROM AUTHOR]

Upregulation of CXCR2 in tumor cells has been documented in several types of cancer. As one of its ligands, CXCL5 is associated with neutrophil infiltration and poor prognosis in hepatocellular carcinoma (HCC). However, little is known about the role of the CXCR2/CXCL5 axis in the invasion and metastasis of HCC cells. In this study, we examined CXCR2 expression in human HCC cell lines and in three independent cohorts of HCC patients. The molecular effects of high expression levels of CXCR2 and CXCL5 in HCC cells were determined using qRT-PCR, western blot analysis, immunofluorescence, matrigel invasion assay, and xenograft mouse models. We found that high levels of CXCR2 correlated with progression and poor prognosis in human HCC. CXCR2/CXCL5 together promoted cell spreading by inducing the epithelial–mesenchymal transition (EMT) through activation of the PI3K/Akt/GSK-3β/Snail signaling pathway. In clinical HCC samples, high expression of both CXCR2 and CXCL5 showed a significant correlation with the activation of PI3K/Akt/GSK-3β/Snail signaling and EMT phenotype. In conclusion, our data showed that the CXCR2/CXCL5 axis contributes to EMT of HCC cells through activating PI3K/Akt/GSK-3β/Snail signaling, and it may serve as a potential therapeutic target. [ABSTRACT FROM AUTHOR]

Background: Sensitive and specific detection of liver cirrhosis is an urgent need for optimal individualized management of disease activity. Substantial studies have identified circulation miRNAs as biomarkers for diverse diseases including chronic liver diseases. In this study, we investigated the plasma miRNA signature to serve as a potential diagnostic biomarker for silent liver cirrhosis. Methods: A genome-wide miRNA microarray was first performed in 80 plasma specimens. Six candidate miRNAs were selected and then trained in CHB-related cirrhosis and controls by qPCR. A classifier, miR-106b and miR-181b, was validated finally in two independent cohorts including CHB-related silent cirrhosis and controls, as well as non−CHB-related cirrhosis and controls as validation sets, respectively. Results: A profile of 2 miRNAs (miR-106b and miR-181b) was identified as liver cirrhosis biomarkers irrespective of etiology. The classifier constructed by the two miRNAs provided a high diagnostic accuracy for cirrhosis (AUC = 0.882 for CHB-related cirrhosis in the training set, 0.774 for CHB-related silent cirrhosis in one validation set, and 0.915 for non−CHB-related cirrhosis in another validation set). Conclusion: Our study demonstrated that the combined detection of miR-106b and miR-181b has a considerable clinical value to diagnose patients with liver cirrhosis, especially those at early stage. [ABSTRACT FROM AUTHOR]

Purpose: An immune function assay has been proposed as a new strategy to monitor immunosuppression after organ transplantation. However, there are limited data regarding its role in liver transplant recipients with hepatocellular carcinoma (HCC). In this study, we sought to determine the utility of this functional assay in assessing the risk of infection, rejection, and tumor recurrence in liver transplant recipients. Methods: Immune function was determined by ImmuKnow assay that measures the amount of adenosine triphosphate (ATP) produced by CD4 (+) T cells to monitor the global immune status in 342 whole blood samples from 105 liver transplant recipients. The association between ATP value and post-transplant tumor recurrence was evaluated in 60 HCC patients. The ATP value in predicting tumor recurrence in other independent cohort of 92 recipients with HCC was analyzed prospectively. Results: The mean ATP values of liver transplant recipients with infection (145.2 ± 87.0 ng/ml) or acute rejection (418.9 ± 169.5 ng/ml) were different from those with stable state (286.6 ± 143.9 ng/ml, P < 0.05). In recipients with HCC who developed recurrent tumors, the values were significantly lower than those without recurrence (137.8 ± 66.4 vs. 289 ± 133.9 ng/ml, P < 0.01); the optimal threshold value to predict post-transplant tumor recurrence was 175 ng/ml. Comparing with the patients in lower immune group (ATP ≤ 175 ng/ml), patients in the higher immune group (ATP > 175 ng/ml) experienced significantly better disease-free survival ( P < 0.01). Multivariate Cox regression analysis showed the ATP value was an independent predictor of HCC recurrence. Conclusions: The immune function assay has the potential to assess the risk of infection and rejection in liver transplantation and to predict post-transplant tumor recurrence in recipients with HCC. [ABSTRACT FROM AUTHOR]

A retrospective cohort study was conducted to identify risk factors for recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection. A total of 317 patients who had received curative resection of pathologically proven small HCC (< or = 3 cm in diameter) were analyzed to ascertain the factors affecting recurrence. The median follow-up period was 33.7 months. Cumulative recurrence rates at 1, 3, and 5 years after resection were 23.5%, 49.5%, and 65.5%, respectively. Male sex, alpha-fetoprotein (AFP) > or = 400 ng/mL, HBV DNA level > or = 4 log(10) copies/mL, prolonged prothrombin time, tumor size > or = 2 cm, microvascular invasion, absence of capsular formation, moderate/poor tumor differentiation, and absence of postoperative interferon-alpha (IFN-alpha) treatment were associated with increased cumulative risk of HCC recurrence. By multivariate analysis, HBV DNA level > or = 4 log(10) copies/mL (P < 0.001, hazard ratio (HR) 2.110), AFP > or = 400 ng/mL (P = 0.011, HR 1.574), microvascular invasion (P < 0.001, HR 1.767), and postoperative IFN-alpha treatment (P = 0.022, HR 0.562) remained to be independently associated with HCC recurrence. Those contributing to late recurrence (>2 years) were older age and HBV DNA level > or = 4 log(10) copies/mL. Patients with persistent HBV DNA level > or = 4 log(10) copies/mL at resection and follow-up had the highest recurrence risk (P < 0.001, HR 4.129). HBV DNA level > or = 4 log(10) copies/mL at the time of resection was the most important risk factor for recurrence. Postoperative IFN-alpha treatment significantly decreased the recurrence risk after resection. [ABSTRACT FROM AUTHOR]